Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | AP5157 | AZ |
NPI | 1043372196 |
---|---|
Provider Name | Mary Lorraine Foehringer |
First Address | Phoenix, AZ 85014-5072 |
Second Address | Phoenix, AZ 85014-5072 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2006 |
Last Update Date | 30/01/2014 |